Is it really a heart attack?

Part 1

Is it really a heart attack?

Recognizing the Differences: Symptoms of Electrolyte Imbalance vs. Heart Attack

by Catherina Pascale

Introduction

Electrolytes—such as sodium, potassium, calcium, and magnesium—are essential minerals that regulate various physiological functions, including nerve conduction, muscle contraction, and hydration. Similarly, cardiovascular health is crucial to sustaining life, with heart attacks representing one of the most critical medical emergencies. Although symptoms of electrolyte imbalances and heart attacks can sometimes overlap, they originate from different mechanisms and require distinct medical interventions. Understanding and differentiating these symptoms can be life-saving.

Electrolytes play a vital role in cardiac function, particularly their influence on myocardial electrical activity and muscle contraction. Standard serum concentrations are tightly regulated, with imbalances potentially leading to dangerous arrhythmias or even lead to cardiac arrest. Potassium, the most impactful electrolyte on cardiac conduction, is affected by pH, hormones, renal function, and medications. Both hyperkalaemia and hypokalaemia can cause life-threatening ECG changes and must be treated accordingly—ranging from dietary correction to intravenous therapies and cardiac protection strategies.

Magnesium, important for potassium regulation, can cause serious neuromuscular and cardiac disturbances when imbalanced. Hypomagnesaemia may result from diuretics, poor dietary intake, or gastrointestinal losses, and can worsen hypokalaemia, necessitating magnesium supplementation. Hypermagnesaemia, though rare, can occur in renal impairment and may cause an atrioventricular block or asystole, that is a failure in the electrical system of the heart resulting in cardiac arrest.

Sodium influences serum osmolality, that is the concentration of solutes, and cardiac action potentials, but cardiac effects usually occur only in extreme deviations. Common symptoms are neurologic rather than cardiac, with treatment involving fluid restriction or diuretics.

Calcium affects the duration of myocardial action potentials and muscle contraction. The QT interval is a measurement of the interval between ventricular depolarization to repolarization. Hypercalcaemia shortens the QT interval and can cause atrioventricular block, while hypocalcaemia prolongs the QT interval, risking cardiac arrest. Both conditions require urgent treatment, typically with fluid therapy, diuretics, or intravenous calcium and magnesium.

Medication is a significant contributor to electrolyte disturbances. Thus it is important to inform clinicians of any medication that the patient is taking so as to better recognize and manage these disturbances promptly to prevent serious cardiac complications (Fhadil & Wright, 2021).

Symptoms of a Heart Attack

A heart attack, or myocardial infarction, occurs when blood flow to part of the heart is blocked, typically by a blood clot. This can cause irreversible damage to the heart muscle. Common symptoms include:

• Chest pain or discomfort: Often described as pressure, tightness, or a squeezing sensation.

• Pain radiating to the arms, jaw, neck, or back

• Shortness of breath: Can occur with or without chest discomfort.

• Nausea, cold sweats, or lightheadedness

• Fatigue: Particularly in women, fatigue can be a key early symptom (Canto et al., 2007).

• Palpitations

Heart attack symptoms often appear suddenly and require immediate medical attention (American Heart Association, 2025).

Electrolyte Imbalance

An imbalance in electrolytes can cause a variety of symptoms such as restlessness, headaches, anxiety, insomnia, thirst, irregular heartbeat, digestive issues, confusion, bone pain, fatigue, and dizziness.

Electrolyte imbalances are typically diagnosed through blood and urine tests, and in severe cases, additional tests such as EKGs or ultrasounds may be required. Key symptoms include irregular heartbeats, often caused by high potassium or calcium levels, which disrupt nerve signals and can trigger anxiety. Muscle weakness, spasms, and cramps may result from low potassium or calcium levels. Digestive issues such as constipation, diarrhea, and nausea can also occur when electrolyte levels are too high or too low.

Bone pain and weakness are linked to high calcium levels, a condition known as hypercalcemia, which may lead to fractures, kidney stones, and fatigue. Electrolyte imbalances can also cause psychological effects such as anxiety and insomnia. These are often due to physical symptoms such as palpitations and muscle spasms. Dizziness and confusion may result from dehydration or elevated sodium levels.

To address electrolyte imbalances, dietary changes are key. Reducing processed food and consuming fresh fruits, vegetables, and dairy products can help restore balance. Potassium-rich foods including bananas, avocados, and leafy greens, as well as calcium-rich dairy products, are beneficial. Proper hydration is also critical. It is important to be aware that dehydration as well as overhydration can disturb electrolyte levels.

Supplements may be necessary for individuals with chronic deficiencies, especially for magnesium and potassium. It is essential to choose high-quality, absorbable vitamins. For those who exercise regularly, it is also important to replace electrolytes lost through sweat by hydrating before, during, and after workouts. Replenishing sodium is particularly important for athletes to prevent symptoms such as cramps, fatigue, and palpitations (Seward, 2018).

Symptoms of Electrolyte Imbalance

Electrolyte deficiency occurs when one or more essential minerals fall below optimal levels. The symptoms can vary depending on the specific electrolyte affected, but common signs include:

• Muscle cramps and spasms: Low levels of calcium, magnesium, or potassium can cause involuntary muscle contractions.

• Fatigue or weakness: Imbalances disrupt cellular energy production and nerve signaling

• Irregular heartbeat (arrhythmias): Especially in cases of low potassium or magnesium (Gennari, 1998).

• Digestive health problems: too high or too low levels of electrolytes and effect digestive muscles

• Bone pain and weakness

• Anxiety and insomnia

• Nausea or vomiting

• Confusion or irritability, dizziness

• Seizures: In severe deficiencies, especially sodium or calcium.

These symptoms typically develop gradually, especially with chronic imbalances. However, acute cases can be life-threatening (Seward, 2018).

Comparison of Symptoms

Symptom	Electrolyte Deficiency (Hinkle, 2011)	Heart Attack (Healthdirect, 2025)
Chest pain	Rare, indirect (e.g. muscle cramp)	Common, often severe
Muscle cramps	Very common	Rare
Irregular heartbeat	Common in severe cases	Common
Fatigue	Gradual onset	Sudden onset possible
Nausea/Vomiting	Possible	Common
Confusion or irritability	Common (especially sodium imbalance)	Less common
Sweating	Rare	Very common
Radiating pain	Rare	Very common

While both conditions can present with fatigue, palpitations, and nausea, a heart attack typically involves intense chest pain and radiating discomfort, while electrolyte deficiency tends to present with muscle cramps and neurological symptoms such as confusion or irritability. Misinterpreting one for the other can delay critical treatment.

Conclusion

Recognizing the key differences between electrolyte deficiency and a heart attack is essential for timely diagnosis and treatment. While some symptoms overlap—such as fatigue and palpitations—the presence of chest pain, radiating discomfort, and profuse sweating are distinct indicators of a heart attack. If in doubt, immediate medical evaluation is advised, particularly when symptoms escalate rapidly.

References

American Heart Association. (2025, April 2). Warning signs of a heart attack. www.heart.org. https://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack

Canto, J. G., Goldberg, R. J., Hand, M. M., Bonow, R. O., Sopko, G., Pepine, C. J., & Long, T. (2007). Symptom presentation of women with acute coronary syndromes: myth vs reality. Archives of Internal Medicine, 167(22), 2405–2413. https://doi.org/10.1001/archinte.167.22.2405

Fhadil, S., & Wright, P. (2021, February 12). Electrolytes in cardiology. The Pharmaceutical Journal, PJ, 14 February 2015, Vol 294, No 7849;294(7849):DOI:10.1211/PJ.2015.20067712 https://pharmaceutical-journal.com/article/ld/electrolytes-in-cardiology

Gennari, F. J. (1998). Hypokalemia. New England Journal of Medicine, 339(7), 451–458. https://doi.org/10.1056/NEJM199808133390707

Healthdirect. (2025, January 23). Heart attack. healthdirect. https://www.healthdirect.gov.au/heart-attack

Hinkle, C. (2011). Electrolyte disorders in the cardiac patient. Critical Care Nursing Clinics of North America, 23(4), 635–643. https://doi.org/10.1016/j.ccell.2011.08.006

Seward, M. (2018, May 10). Symptoms of low electrolytes. Healthy Focus. https://healthyfocus.org/symptoms-of-low-electrolytes

Part 2

Simple Recipes

Dietary habits are important for maintaining electrolyte levels. There is a wide variety of food to choose from to satisfy tastes and meet dietary restrictions. Here are five easy, healthy recipes that almost anyone can prepare, even with minimal cooking experience. Each recipe includes basic ingredients, simple steps, and no complicated equipment. Of course, it is important to keep in mind that these recipes are suggestions, and should be adjusted according to any dietary restrictions, as medically advised.

1. Veggie Stir-Fry with Rice

Prep time: 10 mins | Cook time: 10 mins | Serves: 2

Ingredients:

• 2 cups mixed vegetables (fresh or frozen – e.g., bell peppers, carrots, broccoli)

• 1 tablespoon soy sauce

• 1 teaspoon sesame oil or olive oil

• 1 clove garlic (minced)

• 1 cup cooked rice (white or brown)

Instructions:

1. Heat oil in a pan over medium heat.

2. Add garlic and stir for 30 seconds.

3. Add vegetables and stir-fry for 5–7 minutes until tender.

4. Add soy sauce and cook for 1 more minute.

5. Serve over cooked rice.

   
   

2. Avocado Toast with Egg

Prep time: 5 mins | Cook time: 5 mins | Serves: 1

Ingredients:

• 1 slice whole grain or sourdough bread

• 1 ripe avocado

• 1 egg (boiled, fried, or poached)

• Salt, pepper, and chili flakes (optional)

Instructions:

1. Toast the bread.

2. Mash avocado onto the toast and season with salt and pepper.

3. Top with the cooked egg and sprinkle with chili flakes if desired.

3. Simple Chickpea Salad

Prep time: 10 mins | No cooking required | Serves: 2

Ingredients:

• 1 can chickpeas, drained and rinsed

• 1 small cucumber, chopped

• 1 tomato, chopped

• 2 tablespoons olive oil

• 1 tablespoon lemon juice

• Salt and pepper to taste

Instructions:

1. Combine chickpeas, cucumber, and tomato in a bowl.

2. Add olive oil and lemon juice.

3. Toss and season with salt and pepper.

4. Baked Sweet Potato with Toppings

Prep time: 5 mins | Cook time: 40 mins (or 8 mins in microwave) | Serves: 1

Ingredients:

• 1 medium sweet potato

• 1 tablespoon Greek yogurt or sour cream

• Optional: black beans, cheese, avocado, green onions

Instructions:

1. Pierce sweet potato with a fork and bake at 400°F (200°C) for 40 minutes OR microwave for 8 minutes.

2. Cut open and top with yogurt and optional toppings.

5. Banana Oat Pancakes

Prep time: 5 mins | Cook time: 10 mins | Serves: 2

Ingredients:

• 1 ripe banana

• 2 eggs

• 1/3 cup oats

• 1/2 teaspoon baking powder (optional)

• Oil or butter for cooking

Instructions:

1. Blend or mash all ingredients into a batter.

2. Heat a pan over medium heat and add a bit of oil.

3. Pour small amounts of batter to form pancakes.

4. Cook for 2–3 minutes per side until golden.

Quick Electrolyte Summary by Ingredient:

Ingredient	Sodium	Potassium	Magnesium	Calcium
Soy sauce	✓✓✓
Avocado		✓✓	✓
Banana		✓✓
Chickpeas	✓	✓	✓	✓
Sweet potato		✓✓✓	✓
Tomato (sauce/fresh)	✓	✓
Whole grain bread/oats	✓		✓
Spinach (optional)		✓	✓✓	✓✓
Greek yogurt/cheese	✓			✓✓✓

Here is a shopping list for all five recipes, grouped by category for convenience:

Produce

• Mixed vegetables (fresh or frozen) – 2 cups (e.g., bell peppers, carrots, broccoli)

• 1 clove garlic

• 1 ripe avocado (x2 if using in sweet potato topping too)

• 1 small cucumber

• 1 tomato

• 1 medium sweet potato

• Green onions (optional, for sweet potato topping)

• 1 ripe banana

Canned & Jarred Goods

• 1 can chickpeas

• Black beans (optional, for sweet potato topping)

Condiments, Oils & Spices

• Soy sauce – 1 tbsp

• Sesame oil or olive oil – 1 tsp + 2 tbsp

• Lemon juice – 1 tbsp

• Salt

• Pepper

• Chili flakes (optional)

• Baking powder – ½ tsp (optional)

Grains & Bread

• Whole grain or sourdough bread – 1 slice

• Cooked rice (white or brown) – 1 cup (or uncooked rice if you need to make it)

• Oats – ⅓ cup

Dairy & Eggs

• Eggs – 3 total (1 for toast, 2 for pancakes)

• Greek yogurt or sour cream – 1 tbsp

• Cheese (optional, for sweet potato topping)

Cooking Fats

• Olive oil or butter (for cooking pancakes)

References

Institute of Medicine. (2004). Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. National Academies Press. https://doi.org/10.17226/10925

U.S. Department of Agriculture. (2022). FoodData Central. https://fdc.nal.usda.gov

Harvard T.H. Chan School of Public Health. (n.d.). The Nutrition Source: Electrolytes. https://www.hsph.harvard.edu/nutritionsource/electrolytes

National Institutes of Health Office of Dietary Supplements. (2021). Magnesium Fact Sheet for Health Professionals. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional

National Institutes of Health Office of Dietary Supplements. (2022). Potassium Fact Sheet for Health Professionals. https://ods.od.nih.gov/factsheets/Potassium-HealthProfessional

Assessed and Endorsed by the MedReport Medical Review Board